58 A digital screening and brief intervention tool to help parents and adolescents quit smoking and vaping: Feasibility results from a pilot randomized-controlled trial

Abstract Background Tobacco use is the single greatest preventable cause of mortality in Canada and 15% of Canadian children are exposed to household secondhand smoke. Clinical Effort Against Secondhand Smoke (CEASE) is an effective, cost-efficient intervention for parents accompanying children to medical appointments that offers systematic screening and facilitated access to evidence-based tobacco cessation resources. Objectives This study is a single-blind pilot randomized controlled trial, comparing an adapted version of CEASE (CanCEASE) to usual care in 5 general and specialized paediatric clinics in Montreal. Design/Methods Parents of children 0-17 years old and adolescents 14-17 years old were included if they reported using cigarettes or e-cigarettes in the past 7 days. Data regarding smoking and vaping consumption were collected at baseline and at 1-, 3- and 6-month follow-up through a web-based survey. Our primary outcome was the number of participants recruited per recruitment day. Secondary outcomes included proportion of individuals screened eligible for participation, interest in smoking/vaping cessation and participant retention. Results Among the 280 adolescents and 568 parents screened, 53 adolescents and 74 parents were recruited (recruitment rate: 0.56/day for adolescents and 0.78/day for parents). Most participants were white (87% of adolescents and 85% of parents) and identified as female (55% of adolescents and 73% of parents); 44.6% of parents had not completed post-secondary education. Observed clinic-level vaping and smoking prevalence were 20% (95%CI 15.6-25.3) and 7.9% (95%CI 5.1-11.8) among adolescents and 8.1% (95%CI 6.1-10.7) and 14.6% (95%CI 11.9-17.9) among parents, respectively. More than half of parents who smoked cigarettes, and more than 40% of parents who used e-cigarettes expressed high (≥ 8/10) intention to quit. Retention rates at 6 months were 54.7% (95%CI 40.6-68.2) for adolescents and 51.4% (95%CI 39.5-63) for parents. Among all participants who completed the 6-month questionnaire, interest in obtaining behavioural cessation support and nicotine-replacement-therapy were 7.7% (95%CI 1.3–26.6) and 3.8% (95%CI 0.2–21.6) among adolescents, and 16.1% (95%CI 6.1–34.5) and 22.6% (95%CI 10.3–41.5) among parents, respectively. Conclusion We conclude that screening parents and adolescents for smoking and vaping and delivering an electronic cessation assistance intervention in paediatric clinic waiting rooms was feasible. Our results reveal high interest in quitting smoking and vaping among parent participants, suggesting an important opportunity to offer cessation support in such settings. Next steps include a fully powered randomized-control trial testing the effectiveness of CanCEASE and the development of future interventions targeting adolescents who smoke and use e-cigarettes.